Provider Demographics
NPI:1427343094
Name:LEONG, TRUMAN GIN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TRUMAN
Middle Name:GIN
Last Name:LEONG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5255 E BROADWAY BLVD
Mailing Address - Street 2:T-0179
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-3702
Mailing Address - Country:US
Mailing Address - Phone:520-917-0130
Mailing Address - Fax:520-917-0130
Practice Address - Street 1:5255 E BROADWAY BLVD
Practice Address - Street 2:T-0179
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-3702
Practice Address - Country:US
Practice Address - Phone:520-917-0130
Practice Address - Fax:520-917-0130
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-12
Last Update Date:2011-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS013865183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist